小细胞肺癌的外科治疗

Surgical treatment for small cell lung cancer

目的 回顾性总结 1 45例原发性小细胞肺癌 (SCLC)外科治疗情况 ,评价外科手术在SCLC治疗中的作用。方法 对 1 45例接受过手术 (其中肺叶切除 6 9例 ,全肺切除 6 8例 ,袖式肺叶切除 7例 ,肺段切除 1例 )和化放疗 (IVP ,VP方案 /钴 6 0放疗 )的SCLC病例按照 1 997年国际肺癌分期标准进行回顾性分析。结果 全组总的 1、3及 5年生存率分别为 73 .1 %、2 4 .8%及 1 6 .6 %。ⅠA期的 1、3及 5年生存率分别为 1 0 0 .0 %、80 .0 %及 5 0 .0 % ,ⅠB期分别为 84.6 %、3 0 .8%及 2 3 .1 % ,ⅡA期分别为 91 .7%、83 .3 %和 6 6 .7%。 2 3例患者达到长期存活。首选手术或放化疗后手术者间生存率无显著性差异。结论 手术可作为SCLC的重要治疗手段 。

Objective To summarize the experience of surgery for small cell lung cancer (SCLC) and to evaluate the role of surgery in treatment of SCLC. Methods A retrospective study undertaken in 145 patients with SCLC who had undergone pulmonary resection(Lobectomy 69,pneumonectomy 68,sleeve lobectomy 7 and segmentectomy 1)combined with chemo/radio(IVP,VP/Co 60 ) therapy according to the new international staging system (1997 System). Results The 1 , 3 , 5 year overall survival rate was 73.1% (106/145), 24.8% (36/145) and 16.6% (24/145) respectively. The 1 , 3 , 5 year survival rate was 100.0%, 80.0% and 50.0% for p stage ⅠA, 84.6%, 30.8% and 23.1% for p stage ⅠB , 91.7%, 83.3% and 66.7% for p stage ⅡA. Twenty three patients were the long term survivals. In addition, no difference of survival rate between the patients who selected surgery or chemo/radio therapy as first treatment. Conclusion These results suggest that operation should be considered as an important treatment choice and combined with chemotherapy for the SCLC.